Oncologist Appointment Today

I had my 6 month oncologist appointment today (a little more than 6 months since my last one, since the hospital messed up my last appointment). Everything looks good.

It didn't start well. It was probably the earliest appointment I've ever had -- blood draw at 7:30am and then seeing the Doc at 8:00am. I'm an early riser, so that was OK, but it meant I had to miss my morning 2 hour walk with my wife. Lots going on at work and home, too, so I was more distracted than usual.

I ended up going into the wrong parking garage (the one at the cancer hospital gives free or reduced parking to patients), and then when I realized my mistake, I went out the wrong exit, and it put me directly on an interstate freeway. So I had to drive to the next exit, turn around, and start all over again. 

Not a great way to start the day.

The hospital has strict policies about how to enter, so I went through that process to get in -- answering Covid questions, getting my temperature taken (by a machine, and not being able to line up my forehead correctly).  When I went a month ago, there was an army of people making sure only one person got into the elevator at a time, and giving directions for where to go. Not this time. They gave me a Visitor sticker and sent me on my way.

Now, where I live, Connecticut, was hit pretty hard by Covid in the spring, but people have been very good about wearing masks and keeping their distance, and we're now at one of the lowest Covid rates in the U.S. That helps a lot with my anxiety, knowing that there are fewer people around who have the virus and who might spread it. I'm still good about avoiding large crowds, and I always wear a mask around other people, but I'm still not much into big crowds these days.

So I was a little taken aback when I got off the elevator and walked into a crowd of people, all wearing scrubs. Apparently, 7:30am is the time the shifts change, so much of the hospital staff was either leaving work of arriving for work just as I stepped into the hall. It kind of threw me a little. It's the most people I've been around, by far, in the last six months. 

I went to blood draw first, and it was pretty uneventful. I am, and always will be, grateful for phlebotomists who do their job well.

The nice things about being in so early (other than the shift change issue) is that there are so few other people there. I'm guessing my 8:00am was the doc's first appointment of the day, so he has no excuse about being behind.

This morning, I was first seen by a Hematology Fellow, one of a small group of new doctors who have finished their degrees, finished their residency, and are now doing extra work in their chosen specialty. He was a nice young man, who asked me lots of questions and did a physical exam. Before he left to consult with Dr. H, my usual oncologist, I asked him why he chose Hematology/Oncology. He sat himself down (people like it when you ask them questions about themselves, and I genuinely like to hear people tell me their stories). He said he seriously considered being a General Practitioner, because he liked the idea of having a relationship with a patient for a long time. But he also knew that so many of the issues that a GP deals with don't really have solutions (people will live with high blood pressure, for example, for their whole lives). While he was in medical school, trying out different specialties, he found himself drawn to cancer patients. He thinks Hematology/Oncology will let him have long relationships with patients, but because there are so many new advances in blood cancer treatment, he'll also be able help fix their problems. He apologized for being "long-winded," but I told him it was really good answer. (And it says something that someone so new to the field thinks treatments are improving so much that he'll be able to help them.)

The Fellow left, and after a few minutes of consulting with Dr. H, they both returned, and I went through the whole thing again, answer questions and getting a physical exam, this time from Dr. H.

He said my blood work looks great. (I don't usually check myself, if the doc thinks it's OK, but so much of what we do now is through tele-health, so I'm on my "patient portal" more than I'd like to be. So I checked my numbers after the appointment, and I have to say, they look good.)

A couple of other interesting bits from our conversation:

He thinks a Covid vaccine will be available sometime in the spring. He also thinks that I should consider myself "medium priority." The people who should get the vaccine first are the elderly (I'm not there quite yet) and those who are in active cancer treatment, and thus have more compromised immune systems. Given how long it's been since I had treatment, my immune system has recovered somewhat from the Rituxan. This, however, is his (admittedly informed) opinion, and not set in stone. But it does give me a better sense of perhaps how I see myself in the middle of the pandemic -- not of the highest priority, but still taking it very seriously. 

He also mentioned possible treatments, if and when they become necessary. He thinks, right now, given the way my FL has stayed in check, he would probably recommend Rituxan again, or maybe Obinituzumab. He also mentioned CAR-T, and expects it to be approved for Relapsed and Refractory Follicular Lymphoma sometime next year. "We may be able to cure this thing," he said. (I told him "I'll believe it when I see it." I'm also optimistic about CAR-T's place, but I'm still not willing to say it's The Cure, at least not in its current version.)

I go back to see him in 7 months. 

A rough start to the day, but a good visit overall. 

I hope al of you are staying healthy, and having good days yourselves.